Tuesday, August 4, 2009

What ABOUT Single Payer

Without demonizing anyone or any party, I’d like to look at Single Payer rationally. Can Single Payer possibly provide me and my family with the same care we’re used to and at a lower cost? Will potentially reduced administrative costs (that’s the theory) translate into lower out of pocket expenses? In short, can we achieve better care at less cost and, in the process, provide healthcare to people who couldn’t otherwise afford it through a federally run “Single Payer” healthcare finance system?

There are questions I must, for the moment, ignore. They are:

Is providing the financial means by which our citizens can obtain health care our governments responsibility?


By what reasonable interpretation of what existing clause or article of our constitution can we possibly infer that responsibility?

If we ignore those questions and assume, as an intellectual exercise, that it IS our federal government’s responsibility, than we are left trying to decide what is the best way, the most efficient way, the most humane way, the most moral way, the most ethical way, and the most complete way to fulfill the obligations that responsibility entails.

First of all and most primary, the POINT of healthcare needs to be decided upon. I submit that the first, the primary, and the ONLY point of healthcare is to maintain and restore health and to prolong life. It is NOT the point of healthcare to hasten death. No medical professional or facility, paid for in whole or in part out of the public fund, should ever be engaged in any process or technique by which any life is forcibly and willfully terminated.

Abortion and euthanasia, in particular, should not be paid for by any public plan or under any public option. So long as both remain legal, they could be provided by the supporters of the same to those who need and they can provide them to those who can’t afford them as a “charitable” service. And they can define charity however they please behind closed doors and out of the public square.

But charity in the context of healthcare is most readily defined as that which aims to promote good health and long life, indifferent to subjective concerns. And age, race, size, class, etc. are, as far as health care should be concerned, subjective. The objective reality that should be recognized is that all human beings, from the first to the last beat of their heart, are absolutely equal in value and in measure. No positive steps should ever be taken in a medical context to permanently stop a beating human heart.

Now, as an aside, I personally believe—and I believe it objectively true—that human life begins at conception. A humans heart beats for the first time, on average, three weeks from conception. As a matter of public policy, I believe that humanity should be recognized and protected in its totality but I also recognize that we, as a nation, are a long way from that ideal. And I don’t think we’ll be able to end THAT debate before we are pressured to end the health care debate. A public option will be on the table and will have to be decided upon with certain decisions as to what gets covered needing to be made immediately. So rather than accept a solution that, by default, may provide pregnancy termination services at ANY stage in a woman’s pregnancy, I’d like to get some parameters defined.

I think that a heart beat is a good, solid, empirically verifiable indicator of a human life that is worthy of and deserving of our protection. Promoting this distinction, rather than a more scientific or philosophical one, will put the onus on those who contend that having a heart that beats on its own is not a sufficient indicator that human life is present. They’ll have to defend their own distinction. And I content—unequivocally—that birth is not a proper distinction. It is, rather, a nonsensical distinction in the age of c-sections on demand. And neither is fetal viability a reasonable distinction since viability has become a sliding scale. How will such a distinction be maintained once the scale has slid all the way down to conception?

So, getting past that messy part of the business, we can focus on that which actually promotes health.

Is Single Payer the best option? Is it a POOR option? Will heath care be rationed? Will people have to wait in long lines for routine care? For emergency care?

Is Single Payer really something we need to be afraid of or is it merely the unknown that is causing us fear.

I admit I don’t know.

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